Collagen Cross-linking for Late-onset Bleb Leakage: 1-Year Results

To assess the efficacy of collagen cross-linking in the treatment of late-onset bleb leakage.

A retrospective, interventional case-series. Cross-linking was performed for late-onset bleb leakage after failure of standard medical therapy. Primary outcome is measured by complete resolution of bleb leakage. Secondary outcomes including intraocular pressure and corrected distance visual acuity (CDVA) were documented over 1 year and were analyzed using repeated measure ANOVA.

Seven patients underwent cross-linking for bleb leakage between 2012 and 2013. Five (71%) had complete resolution of bleb leakage. Intraocular pressure improved from 3.9±1.0 to 7.4±1.1 mm Hg at 1 to 2 months (P=0.0003) and remained at 9.6±3.0 mm Hg at final visit (P=0.06). The corresponding CDVA also improved from 0.6±0.2 to 0.38±0.37 logMAR (P=0.0069) at 1 to 2 months before stabilizing at 0.38±0.44 (P=0.0021) at 1 year. Two cases (29%) had persistent bleb leakage after treatment. Four patients (57%) had resolved hypotony (≥6 mm Hg) at final visit. No adverse event was reported.

Collagen cross-linking is a noninvasive treatment offering reasonable success rate for filtering bleb leakage, and may spare patients invasive surgical bleb revisions.